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January 8 CKAHU
The document summarizes the current state of health reform in the United States after the Supreme Court ruling upholding the Affordable Care Act. It discusses public opinion polls showing that a majority of Americans oppose the health reform law and believe it will make things worse. It also outlines ongoing resistance movements from governors, citizens, employers, and Congress. The document analyzes impacts on employers from new taxes and penalties as well as effects on employees from rising costs and responsibilities under the reform. It concludes by arguing for market-based, state-led alternatives that enhance choice, value, and focus on the patient rather than government control over healthcare decisions.
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January 8 CKAHU
- 1. Health Reform: A not-for-profit health and tax policy research organization Where are we now? Grace-Marie Turner January 8, 2013 Central Kentucky Association of Health Underwriters /GalenInstitute www.galen.org
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- 15. Source: Ari Melber,”POLL:Half of Americans Don’t Know How Court Ruled on Healthcare,” The Nation, July 4, 2012, http://www.thenation.com/blog/168720/poll-half-americans-dont-know-how-court-ruled-healthcare#.
- 16. Americans agreed ongoals for health reform… • The U.S. needs health reform to: – make coverage more affordable – assure quality, and – expand access to insurance • Most people rate their own coverage as good or excellent • They want stability. Change is for others. www.galen.org
- 17. Americans’ views ofhealth law after Supreme Court decision • Americans say it will make things worse rather than better for taxpayers, businesses, doctors, and those who currently have health insurance. • Opposition to the law higher after Supreme Court decision. Sources: “Americans: Healthcare Law Helps Some, Hurts Others ,” Gallup, July 16, 2012, http://www.gallup.com/poll/155726/Americans-Healthcare-Law- Helps-Hurts-Others.aspx?utm_source=add%2Bthis&utm_medium=addthis.com&utm_campaign=sharing#.UARkmBS6osE.twitter. The New York Times/CBS News Poll, July 11-16, 2012, http://s3.documentcloud.org/documents/402362/jul12a-ocr.pdf. “Kaiser Health Tracking Poll,” The Kaiser Family Foundation, July 2012, http://www.kff.org/kaiserpolls/upload/8339-C.pdf
- 18. Source: “Kaiser HealthTracking Poll: July 2012,” The Henry J. Kaiser Family Foundation, July 31, 2012, http://www.kff.org/kaiserpolls/8339.cfm.
- 19. Majority of AmericansOppose Government Health Care Gallup asked: Do you think it is the responsibility of the federal government to make sure all Americans have healthcare coverage, or is that not the responsibility of the federal government? % Government responsibility % Not government responsibility 69 64 64 64 62 62 59 58 54 54 50 50 50 47 47 46 44 41 39 38 34 35 34 33 31 28 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2012 2011 2012 Source: Jeffrey M. Jones, “Now Against Gov't Healthcare Guarantee,” Gallup Politics, November 28, 2012, http://www.gallup.com/poll/158966/majority-against-gov-healthcare-guarantee.aspx.
- 21. The health lawin one graph Source: Avik Roy, “Fact-Checking the Obama Campaign's Defense of its $716 Billion Cut to Medicare,” Forbes: The Apothecary, August 16, 2012, http://www.forbes.com/sites/aroy/2012/08/16/fact-checking-the-obama-campaigns-defense-of-its-716-billion-cut-to-medicare/.
- 23. Why ObamaCare isn’tsettled 38% of Americans supported the law in the last major poll before the November elections Of the 50.6% who voted for President Obama… 12% said they wanted the law repealed The election was not about ObamaCare Source: “Kaiser Health Tracking Poll: October 2012,” The Henry J. Kaiser Family Foundation, October 31, 2012, http://www.kff.org/kaiserpolls/8381.cfm.
- 24. ObamaCare Resistance Movement Governors:No exchanges or Medicaid expansion Citizens: Pay fine rather than buy insurance Employers: Seeking ways to avoid fines Congress: Delay, defund, dismantle, do strict oversight Legal challenges: 40 and counting, including challenge to religious liberty
- 25. State Actions toAddress Health Insurance Exchanges Pursuing state-run State plans to State has not Pursuing state-run State not establishing exchange: enacted partner with federal declared their exchange: executive a state-run exchange legislation government plan to HHS branch Source: “State Actions to Address Health Insurance Exchanges,” National Conference of State Legislatures, December 20, 2012, http://www.ncsl.org/issues-research/health/state-actions-to-implement-the-health-benefit-exch.aspx.
- 26. Exchange bureaucracy Source: SarahKliff, “Is ObamaCare too much work for the Obama administration?” The Washington Post, November 12, 2012, http://www.washingtonpost.com/blogs/wonkblog/wp/2012/11/12/is-obamacare-too-much-work-for-the-obama-administration/.
- 28. ObamaCare’s New Taxes Source:Philip Dittmer and William McBride, “Obamacare's New Taxes, And How You May Be Affected,” Tax Foundation, July 5, 2012, http://taxfoundation.org/blog/obamacares-new-taxes-and-how-you-may-be-affected.
- 29. More ObamaCare Taxes Source:Philip Dittmer and William McBride, “Obamacare's New Taxes, And How You May Be Affected,” Tax Foundation, July 5, 2012, http://taxfoundation.org/blog/obamacares-new-taxes-and-how-you-may-be-affected.
- 30. Mercer: Employers planningworkforce changes w Mercer study on what employers expect Source: “Health Reform Poses Biggest Challenges to Companies with the Most Part-Time and Low-Paid Employees,” Mercer LLC, August 8, 2012, http://www.mercer.com/press-releases/1472805.
- 31. Employer mandate penalties For companies with +50 employees • $2,000 per year per full-time employee for not providing coverage (minus first 30) • $3,000 per year for any employee getting insurance through the Exchanges * If an employer offers employee-only coverage that’s “affordable” to the worker, family members are not eligible for Exchange subsidies www.galen.org
- 32. Some things tothink about 1. Employers with <50 FTE EE’s have no 3k/2k penalty 2. But employers offering qualified and affordable coverage may actually be hurting their employees Example SCOTUS Success Boot Camp
- 33. Generous Subsidies in Examples:Exchanges • A person earning $42,000 a year with a family of 4 qualifies for $14,759 in new health insurance subsidies • A single person earning $20,600 qualifies for $5,156 in new health insurance subsidies But only if employer doesn’t offer coverage or if it’s not “affordable” (ie costs >9.5% of income) www.galen.org
- 34. But employee sharestill steep Examples: • A young family earning $35,000 a year would have to pay up to $5,555 in total health costs for a $12,130 Silver plan ($1,388/prem.; $4,167 OOP) • A slightly older family earning $85,000 would have to pay up to $16,408 in total health costs for a $15,116 Silver plan ($8,075/prem.; $8,333 OOP) Source: Estimates based upon the Kaiser Family Foundation’s Health Reform Subsidy Calculator, http://healthreform.kff.org/subsidycalculator.aspx. Grace-Marie Turner, “ObamaCare: Pain 2.0,” New York Post, December 27, 2012, http://tinyurl.com/ag92fgv.
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- 36. What we knowfor sure • CHOICE: Americans value innovation, diversity and choice to accommodate 300 million people • VALUE IN HEALTH SPENDING: To realize the promise of personalized medicine and achieve overall cost saving, break down payment silos • FOCUS ON THE PATIENT: They want doctors and patients, not government, to make health care decisions
- 37. Source: Frank Hill,“The High Cost Impact of More Regulation and Admin/Executive Staff on Health Care Inflation,” Telemachus, July 22, 2012, http://www.telemachusleaps.com/2012/07/the-high-cost-impact-of-more-regulation.html.
- 38. A market-based solution “Definedcontributions” for health coverage A system that puts doctors and patients in charge of medical decisions Restructuring financing for a 21st century health sector • Medicare • Medicaid • Private Insurance
- 39. States have abig role Seek ways improve their markets • Enhance competition for more choices of affordable coverage • Better safety net with functional high-risk pools • Private exchanges? • What suggestions can you present? www.galen.org
- 40. Even Europeans goingthe other way • Consumerism • Value of private enterprise and competition • Doctor-patient relationship • Decentralized decision-making www.galen.org
- 41. The future? • The global move toward consumerism is real, driven by greater patient demand for more control over decisions. • People will seek more affordable options outside the ACA’s centralized control. Search for your opportunities!
- 42. Why ObamaCare IsWrong for America How does the health care law drive up costs? Is your doctor really in charge of your health care decisions? Are your Constitutional rights threatened? Discover the law’s impact on your life in a new book from four nationally recognized health policy experts Published by Broadside Books, an imprint of HarperCollins www.WrongForAmericaBook.com www.galen.org
- 43. Grace-Marie Turner A not-for-profit health and tax policy research organization Galen Institute 703-299-8900 gracemarie@galen.org twitter.com/GalenInstitute facebook.com/GalenInstitute Subscribe to our free email alerts at /GalenInstitute www.galen.org www.galen.org/subscribe